Co Dependent Nation!

“The available evidence indicates that the war on drugs is a failed war”, so says Former Brazilian president Fernando Henrique Cardosa. Latin America has grown weary of a failed drug policy and endless violence.  In reading the perspective of Latin America, it’s remarkable how they play the addict to the co-dependant of the US. Just like a sanctimonious co dependant, the U.S. blames the Columbians and other nations for producing the products. Meanwhile we are the consumers. They have to be selling it to someone!!  

The dance of the addict and co dependant is a difficult one to unravel. Co dependants don’t see that they are as sick as the addict, often sicker and so they try to control consumption by controlling availability and blaming. How many of us are guilty of flushing drugs down the toilet or throwing away bottles? This can be done forever and yet the addict will drink and use again. It’s a similar dance with U.S. and Latin America. We say to Columbia “Wouldn’t you rather grow chili peppers or flowers?” but we keep snorting coke and we blame the Columbians? We tell scrub farmers trying to feed their families not to grow the most lucrative product, coca. Coca is deeply ingrained in their culture, contains only trace amounts of cocaine, and is believed to have medicinal purposes. It’s like tea to the English. How far would that go in London?” You have to stop tea production because we don’t like it in America”.  What a mess. What an arrogant, entitled, way to deal with a problem; blaming. with no reflection into our contribution to the problem.  Where is the discourse, the collaboration?

Obama has a unique opportunity to shift this paradigm. He could tariff and regulate products that the American people want and consume. Create a whole new tax base and funding for all kinds of health and human service programs. So what if people want to get high? Who are we to tell them not to? What would be so terrible if you could buy weed at 7-11? What if we did work closely with the Latin American governments and drafted policy that made sense for all Americans, north and south?

Emerson College and their New Amnesty Policy – Good Job!

Emerson College in Boston just announced that they have adopted an amnesty policy when students call for help with alcohol and other drug related emergencies.  So, if a bunch of kids are drinking or doing drugs at Emerson, shocking I know, and someone uses poor judgment, again, shocking, it gives the kids freedom to call for help. There are countless examples of deaths involving situations where the kids involved were afraid to call 911. There is an insightful scene in the film “traffic” where the kids were partying and one overdosed, the others were too afraid to call for help and ended up dumping their friend at the entrance of an ER. 

Is this good policy? Does it encourage undergrads to drink and use drugs? The short answer is no, it does not encourage them to drink. It does encourage them to call for help. In my view, this should be national policy and not just on college campuses but in the community as a whole.

Drug abuse correlates to many things: trauma, genetics, exposure to community violence, and interruption in ones experience with the same sex parent. Heroin addiction correlates to many factors but availability of needles isn’t one of them, and yet, we don’t provide clean needles compounding the public health issues with HIV, Hep C and other diseases.

The time for harm reduction has come. The narrow minded, punitive, tough on “crime” thought process has created a mess, a drain on resources, misery to individuals and families.  College campuses are fairly dangerous places. Kids away from home for the first time, impulsive adolescent energy fueled by drugs and alcohol. Parents of sons will not be shocked to hear that decision making is not a strong suit of even the most grounded boy.  Why then, wouldn’t we do everything we can do to reduce the risk factors? 

My son is 4 years old, so it’s not a concern yet (unless I’m in denial), but if he were at a party and drank to the point of needing medical attention, please let someone call for help. If one of the hurdles is fear of getting in trouble, let’s get rid of that. In the same way that I would prefer my son not have sex until he can be responsible, I think I’ll put condoms in his lunchbox. Proper use of condoms reduces pregnancy and spread of disease and “good Samaritan” policy reduces injury and death!  Kudos to Emerson College!

Arizona and the Drug War.

PHOENIX……. sun, mountains, golf, tacos, beautiful sunsets, oh and violent kidnappings.

It seems as though Phoenix, now a major gateway to bring drugs into the U.S., is also the leading city for violent kidnappings. Last year Phoenix police received 366 reports of kidnappings for ransom. Most of these, according to the Phoenix police, were closely linked to the drug trade in nearby Mexico.

The Bush administration violated untold liberties in fighting the war on terror. Maybe the terrorist’s plan is to divert attention and resources to a “war on terror” while the drug war rages. How is it that we can fight a war on terror, an abstract concept, when there were 366 kidnappings in Phoenix last year? Is nobody paying attention? The only thing that ended the violence of prohibition was to end prohibition. Is this really such a hard lesson to learn?

DAMMAD or DAMMISGUIDED Steven Steiner?

DAMMAD.  Check out this website.  Dammad is a grassroots anti-drug organization created by a parent whose “mission is to help fight against the drug problem”.  The Founder of this organization, Steven Steiner, recently had a press release with the person he thought should be the new drug czar. I’m not sure what Mr. Steiner is basing his decision on but I think he should change the name of his group to DAMMISGUIDED or DAMWAYOFFBASE. It’s a shame because Mr. Steiner seems dedicated and passionate to the memory of his son, who died of a drug overdose, but he’s way off base here. It’s a tragic situation, but was his son a casualty of the drug war that his father advocates?

            It’s tough to decide which area of DAMMAD to comment, there are so many bizarre aspects of it. Let’s start with the name. Dads and Mad Moms against drug dealers:  hmmmmm….are there any parents out there actually FOR drug dealers? Where are these pro drug dealer parents? Let’s capture them; a bunch of hippies no doubt. My second comment is really a question for Mr. Steiner: Isn’t it ironic that you have the very company who manufactures and sells (deals) the drug that killed your son listed as a supporter on your website? Also listed is a mini mart – I have no idea, but I speculate that this mini mart sells 40’s and cigarettes. 40’s, liquid crack and nicotine available to junior high kids? I know, I know, they are not of legal age, doesn’t mean they can’t get it!

            One of Mr. Steiner’s strong oppositions is the decriminalization of marijuana.  If his sons chosen intoxicant were marijuana, the kid would be alive today.  He may be functioning at a low level, complacent, blankly staring at video games but he would be alive and there may be hope to engage this young man into treatment.

            Luckily, with his miss the mark advocacy, Steven Steiner won’t be choosing the next drug czar. Clearly with my keen insight and ability to critique almost everyone, I should.  And here’s what I would do: I select ending the post. Czar? I would create a new post. A composite of multidisciplinary professionals. Doctors, social workers, recovery advocates, and lawyers. Steering this committee would be Joe Califano. When I had time, I would gladly head to Washington and dust off my soapbox. It’s hard to demonize Steven Steiner, first off, he lost his son and he seems genuinely concerned about an issue that goes largely unexamined. I welcome a public forum with him. Come to my Loft (sober living facility in Brooklyn, NY) Mr. Steiner and lets chat, we can film it and post it on YouTube and then seek comments, not to find out who is right but to support discourse in the community. 

Joaquin Phoenix, Mental Illness and David Letterman!

Years ago, Letterman poked fun at Andy Kaufman as he slowly declined into mental illness. It was funny to some; the banter between them offered entertainment. Last night David Letterman had his snarky response to Joaquin Phoenix and his bizarre appearance on The Letterman show. While Letterman is funny, what Phoenix may be dealing with is not. Why is it OK to make fun of mental illness? Would we laugh at cancer? People look funny when they are bald, so why not laugh at cancer? Could Letterman heckle Patrick Swayze and his appearance?

            Joaquin Phoenix was just 19 when his brother died of an overdose. Here we have trauma and family history of addictive disease perhaps depression.  Those two factors play a crucial role in producing addicts.  His parents, not conventional people, seem genuinely concerned and loving but they raised their five children on the road and had them perform on streets and at talent contests in order to buy food and provide the basic necessities.  They were also members of a religious cult in the 60’s but eventually quit the cult and moved to Los Angeles.   Phoenix was treated for his own alcoholism just four years ago. All of these factors and his recent behavior add up to something. He has the look of a schizophrenic and seems largely detached from what is happening around him. None of this is funny….. Its grief, loss, fear, and an inability to handle fame, an emotional construct that cannot handle his talent. He has twice disappeared from the public eye when his fame got too intense.  Not hard to imagine he would derail. And yet, we snicker; laugh at the smarty pants comments of David Letterman. Mental illness is just that, illness and left untreated it won’t self correct.  It’s also not an oddity to be laughed at. Often times, humor can help tense situations but this was not one of those times. Being a big movie star, one would guess Phoenix has handlers. Where are they now?

U.S. Drug Policy is a Total Failure!

Former Brazilian president, Fernando Henrique Cardoso, in collaboration with former Columbian president Cesar Gauiria and former Mexican president Ernesto Zedillo have announced that the U.S drug policy is a “total failure”.  The situation with drugs in the US is a mess to be sure. Hard to declare it a total failure since the goals and objectives of the policies are not clearly defined, they are not even murkily defined. What are they designed to do? The Latin American presidents called for a more European model in drafting policy, where drug use/abuse is treated by health officials and not by law enforcement. They issued a statement that said “We are very concerned that the policies of narco-trafficking in the U.S. have practically no public debate today”.  I agree!!

My intention is not to minimize the sacrifice and loss of those individuals who have died in Iraq, but I wonder how many young people have died in the drug war during the time we have been in Iraq?  Are the lives of drug addicts less valuable?  In America it is more likely that black males will be incarcerated than go to college. I’m grateful for President Obama who is providing the belief that there is possibility for black, male youth. Go that extra mile Barack! Ending the paramilitary drug war will save lives, torment, revolutionize the culture, help people get into treatment, and reduce harm. Let’s meet with the Latin Americans and collaborate on Western Hemisphere policy.  I’ll volunteer to go with you for support….

Gil Kerlikowske and Obama – Their War on Drugs!

It appears as if Gil Kerlikowske, Seattle police chief, will be taking the job of drug czar for the Obama administration.  Kerlikoske has a reputation of being soft on misconduct issues within the department.  As the son of a cop, I understand the absolute loyalty required for a police force so I won’t fault him for giving the benefit of the doubt to the officers. He also has a reputation for being progressive with drug policy. In a bold move, he made marijuana possession the “lowest priority” for the Seattle Police Department. As it turns out, crime dropped.  You can file that under “Mel Brooks is Jewish” or “Oprah’s weight fluctuates”.

By comparison, Kerlikowske in the role of drug czar looks progressive, especially given the move he made in Seattle. This is concerning for a few reasons. The first is that the office of drug czar has been held by the likes of Barry McCaffrey, an army general. His very presence sent the message that the War on Drugs could be led, and won, by paramilitary force. McCaffrey was a short, angry little man who by his own admission made no impact on the availability of cocaine on the streets of US cities.  During McCaffrey’s tenure in office, the DEA employed Blackhawk helicopters to defoliate coca fields in Columbia as part of “Plan Columbia” which was a “humanitarian” aid package of 3 billion dollars to the Columbian government. What happened? Schoolyards, along with coca fields were defoliated by a technological marvel when a single prop crop duster would have done the same job. As an added bonus, teenage boys in both Columbia and US cities were shot, shot by real guns with real bullets but still the disco dust fell and anyone who wanted to get high with cocaine did. Solid work general!

So here we are with an administration being built on Change. Clearly an African American man in the White House, who purpose there is not to pour tea, is a much needed and welcomed change…. but will that revolution translate to the drug policy?  While Kerlikowske is a “change” it is a half measure, a “sort of change”, “change-lite”. Real change would be naming a health care provider to the post, or a doctor with specific training in addiction. This change is throwing a bone and not a very meaty bone at that. Yes, Kerlikowske has a reputation and record of being “hemp friendly” but consider the population he presides over. Seattle! Home of grunge and “Hemp fest”. It’s a close neighbor to Vancouver, the Amsterdam of North America. Was he really so progressive or did he just have the insight to understand that he simply cannot control a population who uses cannabis as their chosen intoxicant? I don’t know the answer but if he agrees to meet with me, I’ll ask him. Kerlikoske is a law enforcement official.  His knowledge, values, and skills are that of a cop. The problem with that is the fact that “policing” addicts doesn’t help them and so we are still living in a culture where chemical abuse, a mental health issue, is being handled by law enforcement. Change?  Perhaps. Maybe “giving in” to the hippie population of Seattle won’t go over on a national level. There’s a possibility that I am way off base and the office will take a baby step toward decriminalizing marijuana. We could even experience a grass roots movement by marijuana users themselves to implement change, although it’s highly unlikely considering their ambition and work ethic.  So, maybe America will move toward more honesty and recognize that people like getting high, which they do in a variety of ways and they will continue to do no matter who holds the office of drug czar.  Personally, I can’t stand the smell of pot, nor the dirty hacky sack culture that often goes with it but I support the right to choose your own method of intoxication regardless of what the DEA says.

 

The Blame Game With Erin and Elizabeth Brockovich!

In a recent interview, Erin and Elizabeth Brockovich disclosed that 17-year-old Elizabeth has been treated for a chemical dependency.  She blames an absent mother for her addictive disease. Swing and a miss, Elizabeth! While this is a common theory, especially among addicts themselves, addiction is a complicated illness without any clear recipe for what makes an addict.  For parents, being blamed is part of the job description, especially for parents of adolescents. Many parents eager to assuage their own guilt about the situation readily accept the causal relationship. That’s a narcissistic, overly simplified view, and one that does not serve the individual achieving remission. If you caused it, you can cure it is the thinking and neither is true. The happy news for the Brockovich family is that this silly, indulgent, and inappropriate view of her situation is coming from an actual adolescent. Many times parents sit in my office, disclosing their story and by the way they are talking about the identified patient, one would swear that the individual is 15 years old… but they are actually 40! Take care of this now Erin, with the tenacity of what made you famous, learn, follow instructions of the solid people at Visions, learn to support Elizabeth in a meaningful way and she will be blossom in ways you can’t even imagine.

            So, if Erin herself is not to blame, what is? What makes an addict? Good questions with only speculation as the answer but here goes:

Genetics: Addictive disease is genetic. When families have an addict, the risk factors for the next generation are high, just as with any other disease process. This is a complicated thing for many people to understand because denial in families is often dense and well crafted.

      Trauma: Trauma occurs every day. The world is full of landmines and pitfalls. We all have fundamental failings that inflict pain on the people around us. Based on the film, there was plenty of trauma at the Brockovich house. Leaving the kids with a biker stranger? Interesting choice, but that may have been the best of a difficult situation. Erin to blame? No. Traumatic? Yes.  Trauma could even be a perfect stranger pontificating in a blog about a family he has never met. Trauma means different things to different people. Addicts being highly sensitive people are vulnerable to traumatic experience, which will dislodge addictive tendency.

Exposure: There is a cultural expectation that teenagers will “experiment”. When one is 12 and you split three beers among a sleepover while Mom and Dad are out to dinner, that’s an experiment. The experiment doesn’t take much time, beyond that scenario, the experiment is over, and then it’s use. For some it becomes abuse.

            To an addict, life feels like an itchy wool sweater that won’t come off. There is resistance to acceptance, a lack of ability to self soothe. When a young person finds the right intoxicant, the world comes into focus, it makes sense, and the pains of ordinary experience melt away. Compound this with family dynamics, trauma, and genetics, entitlement of the addict, cultural tolerance, the family believing this is a lesson to learn and a million other contributing factors. An absent mother? Maybe it didn’t help. We have also heard “my mother was controlling”, “My mother was smothering” and a million other reasons as to why individuals develop into addicts. I think the truth is, nobody really knows.  Addicts will always find a reason to use, even when you tell them not to.

            My sincere hope for this young woman is that she finds her recovery on her terms, accepts herself as a mix of good and bad traits. I hope she learns to accept that her mother did the best she could with what she had at the time. Blame never gets anyone very far, easy to say, a lifetime of internal work to feel.

 

An Insiders View of the Betty Ford Clinic.

If you were to look up RECOVERY in a picture dictionary, chances are there would be a picture of The Betty Ford Center representing it.  The Betty Ford center (BFC) is a recovery pillar, a groundbreaker and pioneer in the recovery culture and movement. Long before young stars like Lindsey or Britney sought help to wrestle their demons, the Betty Ford Center saw many cultural elites on their expansive manicured lawns. There was a day when BFC was routinely mentioned in Johnny Carson’s monologues, was fodder for backyard bbq conversations, and was a staple in supermarket tabloids.  To those of us who make a living in the commerce of care we owe a huge debt of gratitude to the center and to Betty Ford herself. Where would we be if she had not had the courage to self disclose, organize her friends and funnel her celebrity into something that has changed the face of addiction treatment and the sub culture of 12 steppin’ – West coast style? 

Today the center has been in operation for more than 25 years, has an endowment of more than 20 million dollars, 80,000 alumni and continues to establish standards of care and develop new programming. On a recent visit to “The Betty” I had the pleasure of seeing their children’s program, a brilliant and effective approach to introducing children, already hurt by the ripple effect of alcoholism, to the knowledge, values, and skills of recovery. Well done Betty! I have always had a particular interest in youth traumatized by addictive disease and the treatment of that. Disney knows “get them young” and you have a lifelong customer, cigarette companies seem to have clued in as well, I think it’s time we do too and thanks Betty for such an innovative and pioneering program!

While The Betty is a tremendous system, it is not without its warts. Visiting the Betty Ford center is a similar to what I imagine visiting Betty Herself would be like. I can envision the nervous anticipation of visiting with a former first lady, coupled with respect and brimming with questions and conversation ranging from politics to being a warrior in a more meaningful war on drugs. Unfortunately, reality in this case is similar to a balloon slowly loosing it’s air….The fantasy lunch is much more satisfying.  In reality, the lunch ends with a somewhat disappointed, empty feeling that Betty is a 90-year-old lady who is past her prime and lacking in her energetic vision. It’s much the same with visiting the center; feeling like I’m headed to Lourdes and then realizing, like all things, The Betty is in some ways past it’s prime and is really a mix of good and bad.

The Betty blends in perfectly with its manicured neighbors – it’s very similar to the planned golf communities that surround it, the lawns are freshly mowed, the hedges are perfectly squared off, it’s warm and sunny and everyone seems happy to greet a New Yorker with open arms.  They embrace me in the relief I must feel to be “out of the cold”.  I let them know that I have a coat, but irony is not something of value at the Betty.  The center is organized like a massive university campus; there are departments, halls, a central cafeteria and an organizational system guiding the treatment process. Each hall has its own identity and source of pride. Men are separate from women and interacting is strictly frowned upon. There is an antiseptic feeling at the Betty. It runs, efficiently, as if were run by an empathic navy admiral who has little tolerance for cutting corners.

The Halls are simple, industrial, and clean. They are as exciting as the freshman dorm at a land grant mega university but they seem to do the job. For the entitled, the risk of AMA is high. The Betty is very much grounded in fundamental paradigms of recovery, humility, honesty, and service. Clearly these are important values in any sustained recovery but the pacing of this is important.  As a believer in meeting the client where they are, The Betty is a distant choice for the high profile client.  The staff is friendly, warm, knowledgeable, they seem happy and largely in recovery themselves, something I think helps.  They also seem to be white, retired, and ethnocentric about their desert community. There is an air of superiority, resting on laurels, and self-satisfaction. Like a pre Vatican II church. The Betty seems like a big factory, organized to the point of sacrificing a personal feeling or an individualized program. It can be argued that any treatment experience is as valuable as the relationship with ones primary therapist. The Betty would offer a great chance to work though ones issues with ones granny, given the apparent transference. As with all mental health treatment it is designed by and run by women. A conflict that is clear at the Betty. During the “When you. I feel” group a well-meaning middle-aged woman on the staff said, “When the men of DuPont are unwilling to participate in this exercise, I feel frustrated and sad”.  The group took this comment as criticism, found it off putting and minimized the great effort it takes for a man to identify and discuss any feeling other than “Shut up”.  I think I could have spoken for the guys in the group by responding with “When you nag and minimize, and patronize, I feel like I want you to shut up or go home and watch a soap opera” With such an emphasis on boy’s camp and girls camp, it is concerning that this does not extend to the staff. While there were men on staff, they were few and far between –  the clinicians were primarily middle-aged women. For anyone raised on text messaging and doesn’t know a world without MTV, think twice; think three times before going to the Betty for treatment. Recent developments and demand have created programs which would be much more appropriate placements for a younger population.

            The cafeteria is like everything at The Betty, clean, well run, and “not bad”. The food compares to a “souplantation” or some such mass produced mall like fare.  It was fresh and well prepared. It is as exciting as a mall court, of course, you’re not there for the food. As with high school, the cafeteria sheds light on cliques at the Betty. Patients are mandated to sit with their halls, a sound clinical decision which makes sense. The dining hall looks like an AARP mixer or a dynamic master planned community clubhouse. There are the bulk of the patients who fall one or two deviations from the mean, on the fringes are the self absorbed and indignant young people who look like they have been bribed to visit grandma. In the distance, children from the kids program gleefully dart about, happy to visit grandma and excited to swim in the community pool. The kids are still excited by the endless soft serve ice cream machine.

The Betty is an important system in the world of treatment and recovery.  They have helped thousands of people and untold numbers of families.  They have done more to break through the cycle of shame than any other treatment center.  The children’s program is the only one of its kind.  The cost of the Betty is 25k for 30 days; it’s a treatment value. In a sense they are like another famous Ford, Henry Ford who figured out a system that made a horseless carriage more obtainable. The Betty is a 12step program – they stress fundamentals. In the end, take the crunchy with the smooth, leave your clubs at home and go get spiritual at the Betty, especially if you’re considering sobriety as part of your retirement plan. 

Michael Phelps Unwinds With a Little Help From His Friends!

Since the release of the Michael Phelps picture many opinions have surfaced regarding the role of athletes in the culture, the expectations we hold them to and of course, pot. Some of them seem reasonable “he’s a kid”, some seem less than reasonable, “will a 10 year old who idolizes Phelps think its ok to smoke pot because he does”? One of my favorites comes from columnist David Ramsey “Phelps fills us with shame.”  That’s a bit of an overstatement from Mr. Ramsey.  As far as I know, judgment never helped a drug issue on any level.  Before reading the comments of Ramsey I’d never heard of him but I imagine him to swill scotch and lament the state of the world and the entire drug using culture.

            Universally there is a consensus that Phelps acknowledged “wrong doing”.  It seems odd that he did something “wrong”, other than choosing an intoxicant besides alcohol. Would this be news if Phelps were seen drinking? At his age drunkenness is more than tolerated, it’s encouraged.  Beer swilling is expected from young adult males, certainly athletes are known to imbibe and yet nobody bats an eye. Why then do we demonize Phelps for choosing an intoxicant that is safer than alcohol? The truth is young men + booze= stitches, car accidents, date rape charges, fights, jail, hospitalizations. Young adults + marijuana = complacency, over eating, staring at video games, listening to Pink Floyd, watching “The Big Labowski” repetitively. Given these choices, I am unclear with what Phelps did “wrong”.

            Make no mistake; I am not advocating for the use of Marijuana, it’s a dangerous psycho reactive drug that can derail a developing mind, body, and emotional world, not to mention dislodging mental illness. More than discussing pot, I think the Phelps issue offers a chance to indict alcohol. Demon alcohol. It does more damage than all street drugs combined and yet, parents sit and my office and say “We know he drinks, but we’re grateful he doesn’t use any drugs!” The” Just Say No” era has done grave disservice to supporting chemical dependency as a health issue. It serves for us to continue to view this issue as “right” or “wrong”.  Dealing with chemical dependency is successful to the degree that we can be honest about it and the truth is, Marijuana is a safer intoxicant than alcohol.